Healthcare Provider Details

I. General information

NPI: 1306753470
Provider Name (Legal Business Name): BANNER HEALTH PHYSICIANS COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 BOISE AVE STE 200
LOVELAND CO
80538-5004
US

IV. Provider business mailing address

2901 N CENTRAL AVE STE 160
PHOENIX AZ
85012-2702
US

V. Phone/Fax

Practice location:
  • Phone: 970-810-4650
  • Fax:
Mailing address:
  • Phone: 602-747-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173F00000X
TaxonomySleep Specialist (PhD)
License Number
License Number State

VIII. Authorized Official

Name: PARIS LABRUZZO
Title or Position: SR. DIRECTOR
Credential:
Phone: 408-768-3596